BRUNSWICK FOOT & ANKLE CENTER, LLC (NPI# 1962561480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962561480 |
| Entity Type | Organization |
| Organization Name | BRUNSWICK FOOT & ANKLE CENTER, LLC |
| Practice Address |
2 Union Street Suite 1 Brunswick ME 04011 |
| Practice Telephone | 2077296686 |
| Practice Fax Number | 2077296687 |
| Mailing Telephone | 2077296686 |
| Mailing Fax Number | 2077296687 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-06-18 |
| Authorized Official Name | HILARY LYNN PELLETIER (OWNER / MEMBER) |
| Authorized Official Telephone | 2077296686 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 133310000 | 05 | |
| DEPT OF LABOR | 610202500 | 01 | |
| CIGNA | M186670 | 01 |
| Street Address |
2 UNION STREET SUITE 1 |
| City | BRUNSWICK |
| State | ME |
| Zip Code | 04011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093276370 | Convenientmd LLC | Clinic/Center | 193 Bath Road, Brunswick, ME 04011 | 2019-03-28 |
| 1326571241 | Psychology Specialists of Maine | Psychologist | 14 Maine St., Suite 309, Brunswick, ME 04011 | 2017-04-07 |
| 1992249775 | Avita Brunswick LLC | Alzheimer Center (Dementia Center) | 89 Admiral Fitch Way, Brunswick, ME 04011 | 2016-12-13 |
| 1215303433 | Mary K Kunhardt | Social Worker | 116 Maquoit Rd, Brunswick, ME 04011 | 2015-08-12 |
| 1861803843 | Gretchen Jane Stevens | Counselor | 136 Maine Street, Suite #6, Brunswick, ME 04011 | 2014-05-13 |
| 1356764567 | Kid Function, Inc. | Clinic/Center | 225 Thomas Point Road, Brunswick, ME 04011 | 2014-01-23 |
| 1356788921 | Jacques M. Reynolds | Psychiatry & Neurology | 81 Medical Center Dr # 2400, Brunswick, ME 04011 | 2013-05-23 |
| 1922369891 | Charles Russell Thorp | Pharmacist | 147 Bath Rd, Rtes 1 and 24, Merry Meeting Plaza, Brunswick, ME 04011 | 2012-06-06 |
| 1992076111 | Benjamin C. Tyau | Physician Assistant | 193 Bath Rd, Brunswick, ME 04011 | 2012-01-19 |
| 1841575339 | Bluesage Therapies Inc. | Social Worker | 214 Raymond Road, Brunswick, ME 04011 | 2011-10-15 |
| Find all providers in zip 04011 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407129737 | Universal Medical Ancillary Services | Podiatrist | 3065 Nationwide Pkwy, Brunswick, OH 44212-2361 | 2012-02-16 |
| 1508001710 | Gary M. Grolemund, Dpm PC | Podiatrist | 10 Professional Dr, Brunswick, GA 31520-3774 | 2008-12-03 |
| 1982850277 | Paul H Eisenberg, Dpm Inc | Podiatrist | 3487 Center Rd, Brunswick, OH 44212-3624 | 2008-08-18 |
| 1285793711 | Michael Mcnally | Podiatrist | 85 Baribeau Dr, Brunswick, ME 04011-3249 | 2006-12-08 |
| 1790844223 | Hilary Pelletier | Podiatrist | 85 Baribeau Dr, Brunswick, ME 04011-3249 | 2006-12-08 |
| 1083629893 | Gary M Grolemund | Podiatrist | 10 Professional Dr, Brunswick, GA 31520-3774 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336367416 | Sandy River Podiatry, Pa | Podiatrist | 114 Perham St, Farmington, ME 04938-1520 | 2007-04-23 |
| 1184775447 | Foot & Ankle Center of Southern Maine | Podiatrist | 75 Portland Rd, Kennebunk, ME 04043-6602 | 2007-01-15 |
| 1700933124 | Maurice R Gardner | Podiatrist | 681 Sabattus St, Lewiston, ME 04240-3829 | 2007-01-05 |
| 1003902149 | Peter Tioseco Ocampo | Podiatrist | 25 Plaza Dr, Ste 9, Scarborough, ME 04074-6900 | 2006-10-05 |
| 1003917337 | Kimberly S. Mason | Podiatrist | 357 Plains Rd, Readfield, ME 04355-3125 | 2006-09-26 |
| 1972602423 | Richard Dimario | Podiatrist | 1 Brickyard Lane, Unit A, York, ME 03909 | 2006-09-21 |
| 1659479541 | Christopher A Toth | Podiatrist | 46 Barra Rd Ste 101, Biddeford, ME 04005-9461 | 2006-09-21 |
| 1154425403 | Joseph M Constantine | Podiatrist | 300 Hammond St, Bangor, ME 04401 | 2006-09-08 |
| 1205941952 | Harold E Chamberlin | Podiatrist | 333 Lincoln Street, Kimball Health Ctr, Saco, ME 04072 | 2006-08-21 |
| 1407860232 | Steven Gershman | Podiatrist | 280 Minot Ave, Auburn, ME 04210-4867 | 2006-07-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.